Questions To Ask Your Medical Professional
Here are some helpful questions to ask your healthcare professional about right-sided heart failure:
- What treatment options do I have to manage my condition?
- What kinds of foods should I limit in order to prevent swelling?
- How much fluid should I drink every day?
- How can I stop my heart failure from getting worse?
What Is An Ejection Fraction
An ejection fraction is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. An ejection fraction of 60% means that 60% of the total amount of blood in the left ventricle is pushed out with each heartbeat. A normal ejection fraction is between 50% and 70%.
Organs like the kidneys require a certain amount of pressure as blood flows through them to work properly. A weak pump can reduce this pressure and in turn decrease the ability of other organs, like the kidneys, to do their jobs. This is how heart failure can lead to multiple organ failure and even death.
What Do The Left And Right Sides Of The Heart Do
The two sides of your heart work in different ways to pump blood.
- Left side: Receives oxygen-rich blood from your lungs and delivers it to the rest of your body. The oxygen helps organs, muscles and other tissue do their job.
- Right side: Receives oxygen-poor blood from your body and delivers it to your lungs. From there, you release carbon dioxide and take in more oxygen.
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Articles On Heart Failure Types & Stages
If you have systolic heart failure, the left ventricle of your heart, which pumps most of the blood, has become weak. This may happen because it’s gotten bigger. Since it’s larger, the ventricle can’t contract the way it should. Because of that, your heart doesn’t pump with enough force to push blood throughout your body.
Can A Holter Monitor Detect Heart Failure
Your doctor may recommend a Holter monitor to evaluate your heart health. It provides important information about your heart health in relation to your age, physical exam, medical history, and other tests. A Holter monitor by itself cannot diagnose all types of heart conditions or predict future heart problems.
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How Common Is Heart Failure
In the United States alone, more than six million adults have been diagnosed with heart failure.
Heart failure is usually divided into two categories based on which side of the heart it mainly affects. The right side of the heart collects oxygen-depleted blood from the body and brings it to the lungs to be filled with fresh oxygen. The left side of the heart receives oxygen-rich blood from the lungs and sends it out to the rest of the body.
While the end result is the same, symptoms can vary based on whether the right or left side of the heart is affected.
Verywell / Jessica Olah
Classification Based On Course Of The Disease
Heart failure can develop suddenly, for instance after a heart attack or due to certain heart rhythm problems. This is known as acute heart failure.
But it usually develops gradually over time as a result of a different medical problem, such as permanently high blood pressure. This is known as chronic heart failure.
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When To See A Doctor
Its a good idea to speak with your doctor to check your heart health if you:
- Notice swelling in your legs
- Become winded easily with normal activities
There is no cure for heart failure. Still, with treatment, you can slow the progression of it and stay feeling better for longer.
You should seek immediate medical attention or call 911 if you or a loved one is experiencing:
- Sudden shortness of breath, irregular heartbeat, or chest pain
- Trouble breathing and blood-tinged phlegm
- Fainting or loss of consciousness
What Are The Symptoms Of Heart Failure
The main symptoms of heart failure are:
- Shortness of breath when youre active or resting, because youre not getting enough oxygen.
- Swollen feet, ankles, stomach and around the lower back area, caused by fluid build up.
- Feeling unusually tired or weak because theres not enough blood and oxygen getting to your muscles.
You should see your GP immediately if you begin to experience any of these symptoms.
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Treatments For Heart Failure
Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.
How you’re treated will depend on what is causing your heart failure.
Common treatments include:
- lifestyle changes including eating a healthy diet, exercising regularly and stopping smoking
- medicine a range of medicines can help many people need to take 2 or 3 different types
- devices implanted in your chest these can help control your heart rhythm
- surgery such as a or a heart transplant
Treatment will usually be needed for life.
A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.
Atrial Natriuretic Peptide And B
ANP and BNP are endogenously generated peptides activated in response to atrial and ventricular volume/pressure expansion. ANP and BNP are released from the atria and ventricles, respectively, and both promote vasodilation and natriuresis. Their hemodynamic effects are mediated by decreases in ventricular filling pressures, owing to reductions in cardiac preload and afterload. BNP, in particular, produces selective afferent arteriolar vasodilation and inhibits sodium reabsorption in the proximal convoluted tubule. It also inhibits renin and aldosterone release and, therefore, adrenergic activation. ANP and BNP are elevated in chronic heart failure. BNP especially has potentially important diagnostic, therapeutic, and prognostic implications.
For more information, see the Medscape Drugs & Diseases article Natriuretic Peptides in Congestive Heart Failure.
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Does Pulmonary Hypertension Cause Left Or Right Sided Heart Failure
In people who have pulmonary hypertension, changes in the small blood vessels inside the lungs can lead to increased blood pressure in the right side of the heart. This makes it harder for the heart to pump blood to the lungs. If this high pressure continues, it puts a strain on the right side of the heart.
How Can You Treat Right
Your doctor will come up with a suitable treatment plan for you, which may involvecardiac rehabilitation and surgery.
Unlike left-sided heart failure, the treatments for right-sided heart failure are less straightforward.
The treatment is directed at the underlying causes of right ventricular dysfunction. If you have right-sided heart failure, your doctor will instruct you to manage your symptoms by taking diuretics, eating a low-salt diet, and limiting fluid intake. These treatments are advised for all people with right-sided heart failure.
Other suggested treatments are based on the most likely cause of right-sided heart failure.
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Rh Parameters Associated With Poor Prognosis In Left
Table 3 depicts several RH indexes investigated for prognosis in left-sided HF. The assessment of RV systolic function is a strong predictor of mortality in all HF phenotypes, whatever the parameter engaged. Chief among all, TAPSE is the most used RV systolic index and a strong predictor of mortality in HF.41 Albeit easy to obtain, TAPSE has several intrinsic limitations, such as load-dependency, that make its assessment biased in cases of even modest RV dilation. Indeed, independent groups
When Should I See A Healthcare Provider About Right Heart Failure
If you have chest pains or suspect you may be having a heart attack, call 911 or go to the nearest emergency room.
Get in touch with your healthcare provider if you experience:
- Shortness of breath.
What else should I ask my provider?
If you have right-sided heart failure, ask your provider:
- What treatment is best for me?
- Is there a special diet I should follow?
- Should I go to cardiac rehab?
- Will I need surgery?
- Will I need a heart transplant?
- What can I do to stop heart failure from progressing?
- What medications will I need?
A note from Cleveland Clinic
Right-sided heart failure means the right side of the heart can no longer pump blood efficiently. Fluid builds up in tissues, causing swelling. Treatment focuses on managing symptoms so the disease doesnt worsen. Healthy lifestyle habits, along with cardiac rehab, improve symptoms for many people. Other treatment options include cardiac devices and surgery. If you have shortness of breath, swelling or chest discomfort, talk to your healthcare provider.
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What Causes Heart Failure
There are lots of reasons why you may have heart failure. It can be sudden or it can happen slowly over months or years.
The most common causes of heart failure are:
- a heart attack which can cause long-term damage to your heart, affecting how well the heart can pump.
- high blood pressureâ putting strain on the heart, which over time can lead to heart failure.
- cardiomyopathyâ a disease of the heart muscle. There are different types which can either be inherited or caused by other things, such as viral infections or pregnancy.
Heart failure can also be caused by:
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Causes Of Heart Failure
Heart failure is often the result of a number of problems affecting the heart at the same time.
Conditions that can lead to heart failure include:
- coronary heart disease where the arteries that supply blood to the heart become clogged up with fatty substances , which may cause angina or a heart attack
- high blood pressure this can put extra strain on the heart, which over time can lead to heart failure
- conditions affecting the heart muscle
- heart rhythm problems , such as atrial fibrillation
- damage or other problems with the heart valves
- congenital heart disease birth defects that affect the normal workings of the heart
Sometimes obesity, anaemia, drinking too much alcohol, an overactive thyroid or high pressure in the lungs can also lead to heart failure.
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What Happens When The Left Side Of The Heart Fails
When the left side of the heart is failing, it cant handle the blood it is getting from the lungs. Pressure then builds up in the veins of the lungs, causing fluid to leak into the lung tissues. This may be referred to as congestive heart failure. This causes you to feel short of breath, weak, or dizzy.
About Heart And Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.
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How Is Heart Failure Treated
Your healthcare providers will help you manage any other health conditions that may be causing your heart failure. The goals of treatment are to manage, slow, or reverse heart damage. Treatment may include the following:
- Medicines may be given to help regulate your heart rhythm and lower your blood pressure. You may also need medicines to help decrease extra fluid. Medicines, such as NSAIDs, may be stopped if they are making your heart failure worse. Do not stop any of your medicines on your own.
- Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. In the program you will learn about exercise, relaxation, stress management, and heart-healthy nutrition. Cardiac rehab may be recommended if your heart failure is not severe.
- Oxygen may help you breathe easier if your oxygen level is lower than normal. A CPAP machine may be used to keep your airway open while you sleep.
- Surgery can be done to implant a pacemaker or another device in your chest to regulate your heart rhythm. Other types of surgery can open blocked heart vessels, replace a damaged heart valve, or remove scar tissue.
Outlook For Heart Failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities youre able to do and is often eventually fatal.
But its very difficult to tell how the condition will progress on an individual basis.
Its very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
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Nyha Functional Classification System
The New York Heart Association functional classification considers heart failure symptoms that happen during exercise to determine stage. Patients can go back and forth between stages depending on how well-controlled symptoms are on a given day.
- Stage 1: The person has heart disease, but it isnt yet causing symptoms or limiting activities.
- Stage 2: The person has mild symptoms that only slightly limit activity.
- Stage 3: The person has significant limitations to activities. He or she is only comfortable when resting.
- Stage 4: The person has major limitations and experiences symptoms when at rest.
The Flow Of Blood Through Your Heart
To understand the different types of heart failure, it helps to know how your heart pumps blood:
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What Is Congestive Heart Failure In Cats
Congestive heart failure is a term that refers to the heartâs inability to pump enough blood to the body. Due to this, blood starts to back up into the lungs and fluid accumulates in the chest, abdomen, or both. This lead to further constriction of the heart and lungs, and limits oxygen flow throughout the body. There are many causes of CHF in cats, but the two most common causes are:
- Mitral valve insufficiency , which refers to a leaky mitral valve, which is the valve between the left atrium and the left ventricle.
- Dilated cardiomyopathy , which is when the heart chambers enlarge and lose their ability to contract.
Clinical signs of CHF vary depending on whether the cat has left- or right-sided heart failure.
Right-sided congestive heart failure
This occurs when a heart contraction causes some blood to leak into the right atrium from the right ventricle rather than being pushed through the lungs and becoming oxygenated. As a result, the main circulation system becomes congested with blood, and fluid accumulates in the abdomen, interfering with adequate organ function. Excess fluid might also build up in the limbs and cause swelling known as peripheral edema.
Left-sided congestive heart failure
The main symptoms of heart failure are:
- breathlessness after activity or at rest
- feeling tired most of the time and finding exercise exhausting
- feeling lightheaded or fainting
- swollen ankles and legs
Symptoms can develop quickly or gradually over weeks or months .
Pathophysiologic Characteristics: How Rv Dysfunction Occurs In Left
The right ventricle is a low-resistance and high-compliance chamber that maintains stroke volume and cardiac output according to venous return, resulting in a particular sensitivity to acute changes in RV afterload.9 It has been demonstrated that around 70% of patients with HF demonstrate RV dysfunction, which arises as a consequence of a series of mechanisms, primarily identified in an increased vascular impedance (ie, elevated left atrial pulsatile loading, superimposed pulmonary vascular
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Optimisation Of Rv Preload Afterload And Contractility
Preload optimisation
Critically ill patients may have reduced right heart preload due to volume loss, reduced venous tone from medications, sepsis or vasoplegia, and positive pressure ventilation. Although the Frank-Starling mechanism is preserved in the failing human RV myocardium , the right ventricle has a much flatter Frank-Starling curve than the left ventricle, and therefore RV contractility changes less over a wide range of filling pressures. In conditions where RV output is impaired due to contractile dysfunction but the afterload is normal , a higher preload is needed to maintain forward flow. However, the majority of conditions leading to RHF are characterised by high RV afterload. In these scenarios, reducing excessive RV preload with diuretics or haemofiltration is key to reducing RV dilatation and free wall tension, thereby minimising RV ischaemia and optimising contractility. It is generally agreed that maintaining a moderately high RV diastolic filling pressure of 8-12 mmHg is optimal in RHF. However, the goal of maintaining forward flow may be achievable at more normal filling pressures in individual cases.
Afterload reduction
Improving contractility
Concerning inotropes, in animal models low-dose dobutamine has been shown to restore RV-pulmonary artery coupling and cardiac output better than norepinephrine because of its more pronounced inotropic effect . Given that it is an inodilator, it is preferably used in normotensive patients.
When To Get Medical Advice
See a GP if you experience persistent or gradually worsening symptoms of heart failure.
Call 999 for an ambulance or go to your nearest A& E department as soon as possible if you have sudden or very severe symptoms.
A number of tests can be used to help check how well your heart is working, including blood tests, an ECG and an echocardiogram.
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